PowerPoint Presentation: A POWER POINT PRESENTATION BY DR.SANGEETA CHOWDHRY & DR.SUNIL SHARMA UNDER THE GUIDANCE OF DR. BHUPESH KHAJURIA PROFESSOR AND HEAD DEPARTMENT OF FORENSIC MEDICINE & TOXICOLOGY GOVT. MEDICAL COLLEGE JAMMU (JAMMU AND KASHMIR) 5/22/2013 1 A SUZY PRESENTATION PowerPoint Presentation: FORENSIC PSYCHIATRY 5/22/2013 2 A SUZY PRESENTATION PowerPoint Presentation: When you live in the shadow of insanity, the appearance of another mind that thinks and talks as yours does is sometimes close to a blessed event. 5/22/2013 3 A SUZY PRESENTATION PowerPoint Presentation: When you speak to God it's called praying ; but when God speaks to you it's called schizophrenia. 5/22/2013 4 A SUZY PRESENTATION PowerPoint Presentation: A man might say that he picked a pocket from some uncontrollable impulse, and in that case the law would have an uncontrollable impulse to punish him for it 5/22/2013 5 A SUZY PRESENTATION PowerPoint Presentation: PSYCHIATRY 5/22/2013 6 A SUZY PRESENTATION PowerPoint Presentation: PSYCHIATRY:- It is the branch of medical science which deals with study, diagnosis , treatment, prevention of mental illness and behavioral disorders . 5/22/2013 7 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 8 A SUZY PRESENTATION PowerPoint Presentation: FORENSIC PSYCHIATRY:- deals with the application of psychiatry in the administration of justice . 5/22/2013 9 A SUZY PRESENTATION PowerPoint Presentation: INSANITY OR UNSOUNDNESS OF MIND 5/22/2013 10 A SUZY PRESENTATION PowerPoint Presentation: INSANITY OR UNSOUNDNESS OF MIND:- can be defined as a disease of the mind which effects the personality, mental status, critical faculties, emotional processes and interaction with social environment. 5/22/2013 11 A SUZY PRESENTATION PowerPoint Presentation: MENTALLY ILL PERSON 5/22/2013 12 A SUZY PRESENTATION PowerPoint Presentation: MENTALLY ILL PERSON:- any person who is in need of treatment by reason of any mental disorder other than mental retardation. 5/22/2013 13 A SUZY PRESENTATION SOME COMMON PSYCHIATRY TERMS: SOME COMMON PSYCHIATRY TERMS Abreaction:- This is a release phenomenon where old, forgotten things or events are brought into conscious state again. 5/22/2013 14 A SUZY PRESENTATION PowerPoint Presentation: ABREACTION 5/22/2013 15 A SUZY PRESENTATION AFFECT: AFFECT It is commonly called mood or feeling. 5/22/2013 16 A SUZY PRESENTATION PowerPoint Presentation: AFFECT 5/22/2013 17 A SUZY PRESENTATION AMNESIA: AMNESIA Loss of memory about a person or event is called ‘amnesia’. 5/22/2013 18 A SUZY PRESENTATION PowerPoint Presentation: AMNESIA 5/22/2013 19 A SUZY PRESENTATION APHASIA: APHASIA Loss of sensory or motor ability to express by use of speech or writing is called ‘aphasia’. 5/22/2013 20 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 21 A SUZY PRESENTATION BINET-SIMON TEST: BINET-SIMON TEST It is done to determine the intelligent quotient of an individual. 5/22/2013 22 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 23 A SUZY PRESENTATION CONFABULATION: CONFABULATION Unconscious filling of gaps in memory by imagining experiences or events that have no basis in fact, commonly seen in amnestic syndrome. Confabulation is considered “honest lying,” but is distinct from lying because there is typically no intent to deceive and the individual is unaware that their information is false. 5/22/2013 24 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 25 A SUZY PRESENTATION CIRCUMSTANTIALITY: CIRCUMSTANTIALITY When a person is not able to answer properly, in a straight manner, and keeps on giving irrelevant details or wanders off the subject many times in a conversation, the condition is called circumstantiality. 5/22/2013 26 A SUZY PRESENTATION PowerPoint Presentation: CIRCUMSTANTIALITY 5/22/2013 27 A SUZY PRESENTATION COMPULSION: COMPULSION It is a repetitive behaviour done by an individual in spite of knowing that it is not correct. Examples being, repeatedly washing hands, checking locked premises again and again. 5/22/2013 28 A SUZY PRESENTATION PowerPoint Presentation: COMPULSION 5/22/2013 29 A SUZY PRESENTATION DELIRIUM: DELIRIUM It is an acute reversible mental disorder characterised by confusion and impairment of consciousness, disorientation(most commonly time), emotional lability, hallucination, or illusion and inappropriate, impulsive, irrational or violent behavior. The mental faculty of an individual does not work properly. It may be seen in high grade fevers or due to overwork, mental stress, acute poisoning(dhatura), chronic alcoholics or drug intoxication. 5/22/2013 30 A SUZY PRESENTATION PowerPoint Presentation: DELIRIUM 5/22/2013 31 A SUZY PRESENTATION FUGUE STATE: FUGUE STATE The person becomes a wanderer who keeps on moving from place to place in an altered state of mind. He has episodes of amnesia. This stage is seen in depression, schizophrenia and other mental disorders. 5/22/2013 32 A SUZY PRESENTATION PowerPoint Presentation: FUGUE STATE 5/22/2013 33 A SUZY PRESENTATION ECHOPRAXIA: ECHOPRAXIA Repeating the act of another 5/22/2013 34 A SUZY PRESENTATION PowerPoint Presentation: ECHOPRAXIA 5/22/2013 35 A SUZY PRESENTATION EMPATHY: EMPATHY The degree to which the observer is able to enter into the thoughts and feelings of the patient and establish good contact. 5/22/2013 36 A SUZY PRESENTATION PowerPoint Presentation: EMPATHY 5/22/2013 37 A SUZY PRESENTATION NEGATIVISM: NEGATIVISM Doing just the opposite of what he is asked to do. 5/22/2013 38 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 39 A SUZY PRESENTATION NEURASTHENIA: NEURASTHENIA A condition arising out of physical or mental exhaustion. 5/22/2013 40 A SUZY PRESENTATION PowerPoint Presentation: NEURASTHENIA 5/22/2013 41 A SUZY PRESENTATION PHOBIA : PHOBIA IS AN EXCESSIVE IRRATIONAL FEAR OF A PARTICULAR OBJECT OR SITUATION. 5/22/2013 42 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 43 A SUZY PRESENTATION PARANOIA: PARANOIA Rare psychiatric syndrome marked by the gradual development of a highly elaborate and complex delusional system, generally involving persecutory or grandiose delusions, with few other signs of personality disorientation or thought disorder. 5/22/2013 44 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 45 A SUZY PRESENTATION PARASUICIDE: PARASUICIDE It is a conscious often impulsive, manipulative act, undertaken to get rid of an intolerable situation. (attempted suicide or pseudicide) 5/22/2013 46 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 47 A SUZY PRESENTATION PARASUICIDE STUPOR: STUPOR Used synonymously with mutism and does not necessarily imply a disturbance of consciousness; in catatonic stupor, patients are ordinarily aware of their surroundings. 5/22/2013 48 A SUZY PRESENTATION PowerPoint Presentation: STUPOR 5/22/2013 49 A SUZY PRESENTATION TWILIGHT STATE: TWILIGHT STATE Disturbed consciousness of short duration with hallucination during which the patient may carry out actions of which he has little or no subsequent memory. 5/22/2013 50 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 51 A SUZY PRESENTATION VEGETATIVE SIGNS: VEGETATIVE SIGNS In depression, denoting characteristic symptoms, such as sleep disturbance(especially early morning awakening), decreased appetite, constipation, weight loss and loss of sexual response. 5/22/2013 52 A SUZY PRESENTATION PowerPoint Presentation: VEGETATIVE SIGNS 5/22/2013 53 A SUZY PRESENTATION PSYCHOPATH: PSYCHOPATH psychopath is a person who is neither insane nor mentally ill, but fails to conform to the normal standards of behavior. It refers to individuals who have psychopathic personality. They are usually antisocial and have long criminal records. They have no remorse feeling and are not amenable to counseling. Some of them have extra Y chromosome in their chromatin. 5/22/2013 54 A SUZY PRESENTATION PowerPoint Presentation: PSYCHOPATH 5/22/2013 55 A SUZY PRESENTATION ONEIROID STATES: ONEIROID STATES It is a dream like state which may last for days or weeks. the patient suffers from confusion, amnesia, illusions, hallucination, disorientation agitation and anxiety. 5/22/2013 56 A SUZY PRESENTATION PowerPoint Presentation: ONEIROID STATES 5/22/2013 57 A SUZY PRESENTATION NEUROSIS AND PSYCHOSIS: NEUROSIS AND PSYCHOSIS Neurosis is when a patient suffers from emotional or intellectual disorders which causes subjective distress, but does not lose touch with reality. Psychosis is characterised by gross impairment in reality-testing(with drawl from reality), as if living in a world of fantasy. 5/22/2013 58 A SUZY PRESENTATION PowerPoint Presentation: NEUROSIS PSYCHOSIS 5/22/2013 59 A SUZY PRESENTATION PSYCHOSIS: PSYCHOSIS Psychoses are usually of the following two types: 1. Manic-depressive Psychosis: It is expressed in following two phases: (a) Mania phase: In this, the person is very active, full of life, talking too much, mostly irreverent, the mood is elated and he does some action continuously. But he does not have touch with reality. He can commit any crime during this phase. Sleep is very less. Appetite is also less. 5/22/2013 60 A SUZY PRESENTATION PSYCHOSIS: PSYCHOSIS (b) Depressive phase: It is just the reverse of mania. The person is very sad, mood is depressed. The person sits alone and may speak very little. Touch with reality is not there. He may commit suicide. The motor functions are also quite depressed. A person suffering from manic depressive psychosis may fluctuate between the two phases of mania and depression. It may be possible that the person may be normal between the two phases of mania. This may be lucid interval and the person is completely responsible for his actions. 5/22/2013 61 A SUZY PRESENTATION NEUROSIS: NEUROSIS Neurosis is a minor mental illness. It is of following types: 1 . Anxiety Neurosis: It is a very common variety. The person remains anxious about future events, relationships and individuals. His pulse rate may be high, blood pressure raised, respiratory rate high and he may be sweating. He may be restless, confused and apprehensive. Treatment usually involves counseling and use of anti-anxiety drugs like diazepam. Meditation also helps a lot. 5/22/2013 62 A SUZY PRESENTATION NEUROSIS: NEUROSIS Depression: It is the reverse of anxiety. Here, a person would be aloof, sad and withdrawn. His motor activities would be quite less. He may have a low appetite and may not eat well. However, in chronic cases of depression, the person may keep on eating the whole day, while withdrawn at home and hence may gain weight. The following are the types of depression commonly seen: 5/22/2013 63 A SUZY PRESENTATION NEUROSIS: NEUROSIS Reactive depression: It may be due to some event or situation like the death of spouse or a near one, failure in exam, love, etc. It usually remains there for sometime. Some form of reactive depression is seen in all individuals. Usually, with counseling and use of anti-depressive drugs, most come out of it. 5/22/2013 64 A SUZY PRESENTATION NEUROSIS: NEUROSIS Endogenous depression: It is more serious as its etiology is not known and develops slowly. Early morning awakening, loss of appetite and mood depression are quite common. This depression may be associated with psychosis too, where it carries a bad prognosis. Usually with anti-depressive drugs, most of the individuals recover. 5/22/2013 65 A SUZY PRESENTATION NEUROSIS: NEUROSIS Puerperal depression: A woman who has recently delivered may have depression commonly called ‘puerperal depression’. She may even kill her infant during this time. (d) Involution depression: During the age group of 50–60 years, depression may set in. Delusion of hopelessness and unworthiness may be present. Due to development of hypertension, diabetes or somatic illness, person may get into depression. Counseling, along with drugs is very useful. 5/22/2013 66 A SUZY PRESENTATION NEUROSIS: NEUROSIS Hypochondriacal depression: In this type of neurosis, the person usually complains of vague aches and pains and may keep on visiting many physicians but of no avail. Usually no treatment is effective. 3. Obsessive-compulsive Neurosis: As described earlier, obsession is a foolish thought which a person knows but cannot avoid. But once this thought turns into action, it is called compulsion and may lead to obsessive-compulsive neurosis. Common examples are repeated washing of hands to remove dirt, continuous checking of already locked premises, etc. 5/22/2013 67 A SUZY PRESENTATION NEUROSIS: NEUROSIS Hysterical Neurosis: It is usually seen in females where there may be convulsions or stoppage of breath. Tonic and clonic convulsions are reported. It should always be differentiated from epilepsy, which it can be confused with. In hysterical neurosis, the person will never get hurt or bite the tongue, as it is seen in epilepsy. Some cause or intention can be found out in hysterical neurosis while in epilepsy usually no cause is found. Hysterical neurosis can be treated with counseling or correction of the underlying cause 5/22/2013 68 A SUZY PRESENTATION DIFFERENCE BETWEEN NEUROSIS AND PSYCHOSIS: DIFFERENCE BETWEEN NEUROSIS AND PSYCHOSIS S.NO FEATURE PSYCHOSIS NEUROSIS 1 Contact with reality lost Preserved 2 Interpersonal behavior Marked disturbance in reality and behavior Preserved 3 Empathy Absent Present 4 Insight Absence of understanding current symptoms Symptoms are recognised as undesirable 5 Organic causative factor Present absent 6 Symptoms Delusions. Illusions and hallucinations Usually physical or psychic symptoms 7 Dealing with reality Capacity is grossly reduced Preserved 8 Examples Dementia, Schizophrenia Anxiety, phobia, depression, conversion disorder 5/22/2013 69 A SUZY PRESENTATION SOMNAMBULISM: SOMNAMBULISM This is also called ‘sleep walking’. A person may move around while asleep and may commit some crime or theft, and then come back normally. He may not be aware that he has committed a crime. He will not be held responsible if it is proved that he has done this act while asleep. 5/22/2013 70 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 A SUZY PRESENTATION 71 SOMNAMBULISM COMMON SYMPTOMS OF PSYCHIATRIC DISORDERS: COMMON SYMPTOMS OF PSYCHIATRIC DISORDERS Delusion Hallucination Illusion Impulse Obsession 5/22/2013 72 A SUZY PRESENTATION DELUSION-भ्रम: DELUSION- भ्रम DELUSION IS A FALSE BELIEF IN SOMETHING WHICH IS NOT A FACT, AND THE BELIEF PERSISTS EVEN AFTER ITS FALSITY HAS BEEN CLEARLY DEMONSTRATED. 5/22/2013 73 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 74 A SUZY PRESENTATION TYPES OF DELUSIONS: TYPES OF DELUSIONS GRANDEUR OR EXALTATION PERSECUTION(PARANOID) REFERENCE INFLUENCE INFEDILITY SELF-REPROACH NIHILISTIC HYPOCHONDRIAL OTHER TYPES 5/22/2013 75 A SUZY PRESENTATION DELUSION OF GRANDEUR OR EXALTATION: DELUSION OF GRANDEUR OR EXALTATION The person imagines that he is very rich, powerful, while in reality he may be a pauper and may squander away his money or property. It is usually seen in mania, and may be associated with delusion of persecution. This is a pleasant delusion. 5/22/2013 76 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF GRANDEUR OR EXALTATION 5/22/2013 77 A SUZY PRESENTATION DELUSION OF PERSECUTION/PARANOID: DELUSION OF PERSECUTION/PARANOID The person imagines that people are after him and may kill him, poison him(wife, sons or parents) or harm him, or someone is going to rob his property. The person remains suspicious and depressed and may commit some crime. ( He may commit suicide or kill his family members or innocent person thinking him/her to be his enemy.) 5/22/2013 78 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF PERSECUTION/PARANOID 5/22/2013 79 A SUZY PRESENTATION DELUSION OF REFERENCE: DELUSION OF REFERENCE The person believes that everybody is thinking about him only and is being referred by all agencies, media and persons around him in all matters(usually of negative nature) and this may put him in conflict with the world. 5/22/2013 80 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF REFERENCE 5/22/2013 81 A SUZY PRESENTATION DELUSION OF INFLUENCE/CONTROL : DELUSION OF INFLUENCE/CONTROL The patient complains that his thoughts processes, feelings and actions are being influenced and controlled by some external power, like radio, hypnotism or telepathy. On the basis of this imaginary “command”, he may commit an unlawful act. 5/22/2013 82 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF INFLUENCE/CONTROL 5/22/2013 83 A SUZY PRESENTATION DELUSION OF INFEDILITY/JEALOUSY-OTHELLO SYNDROME : DELUSION OF INFEDILITY/JEALOUSY-OTHELLO SYNDROME In this, the person thinks that his/her spouse is not loyal to him/ her. Usually, males suffer more from this delusion as compared to females. The person may commit crime in this state. 5/22/2013 84 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF INFEDILITY/JEALOUSY-OTHELLO SYNDROME 5/22/2013 85 A SUZY PRESENTATION DELUSION OF SELF-REPROCH OR SELF-CRITICISM: DELUSION OF SELF-REPROCH OR SELF-CRITICISM The person criticises himself for some imaginary offence or misdeed committed by him in the past. In serious cases, the person may punish himself by committing suicide. 5/22/2013 86 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF SELF-REPROCH OR SELF-CRITICISM 5/22/2013 87 A SUZY PRESENTATION NIHILISTIC DELUSION: NIHILISTIC DELUSION In this, the person does not believe in his existence or that the world exists. They may commit suicide or kill others. It is commonly seen in depression. 5/22/2013 88 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 89 A SUZY PRESENTATION HYPOCHONDRIAL DELUSION : HYPOCHONDRIAL DELUSION The person in this delusion thinks that he is ill always, while medically he may be completely fit. He keeps on visiting doctors. Usually the person gives vague abdominal complaints. 5/22/2013 90 A SUZY PRESENTATION PowerPoint Presentation: HYPOCHONDRIAL DELUSION 5/22/2013 91 A SUZY PRESENTATION PowerPoint Presentation: SOME OTHER - DELUSIONS SOME OTHER - DELUSIONS 5/22/2013 92 A SUZY PRESENTATION DELUSION OF POVERTY: DELUSION OF POVERTY The patient is convinced that he is, or will be, bereft of all material possessions. 5/22/2013 93 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF POVERTY 5/22/2013 94 A SUZY PRESENTATION DELUSION OF DOUBLES (DOPPELGANGER): DELUSION OF DOUBLES (DOPPELGANGER) Patient believes that another person has been physically transformed into themselves. 5/22/2013 95 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF DOUBLES (DOPPELGANGER) 5/22/2013 96 A SUZY PRESENTATION EROTOMANIA: EROTOMANIA In this, a women thinks that a particular person, especially superior, is in deeply love with her. The erotomanic develops an obsession for the person and starts believing that the other person is reciprocating The object is usually of a higher status, famous superior at work but can also be a complete stranger. The erotomanic tries to get in close to the person through telephone calls, e-mails, letters, gifts and visits. More common in women than in men. 5/22/2013 97 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 98 A SUZY PRESENTATION DELUSION OF REPLACEMENT OF SIGNIFICANT OTHERS(CAPRAS SYNDROME): DELUSION OF REPLACEMENT OF SIGNIFICANT OTHERS(CAPRAS SYNDROME) Patient believes that someone close to him has been replaced by a exact double. 5/22/2013 99 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF REPLACEMENT OF SIGNIFICANT OTHERS(CAPRAS SYNDROME) 5/22/2013 100 A SUZY PRESENTATION DELUSION OF DISGUISE(FREGOLI’S PHENOMENON): DELUSION OF DISGUISE(FREGOLI’S PHENOMENON) Strangers are identified as familiar people in the patient’s life. 5/22/2013 101 A SUZY PRESENTATION PowerPoint Presentation: DELUSION OF DISGUISE(FREGOLI’S PHENOMENON) 5/22/2013 102 A SUZY PRESENTATION FOLIE A DEUX: FOLIE A DEUX Mental illness shared by two persons, usually involving a common delusional system. 5/22/2013 103 A SUZY PRESENTATION PowerPoint Presentation: FOLIE A DEUX 5/22/2013 104 A SUZY PRESENTATION COTARD DELUSION/SYNDROME: COTARD DELUSION/SYNDROME Person holds a delusional belief that he/she is dead, does not exist. Is putrefying or has lost his blood or internal organs. 5/22/2013 105 A SUZY PRESENTATION PowerPoint Presentation: COTARD DELUSION/SYNDROME 5/22/2013 106 A SUZY PRESENTATION PSEUDOLOGIA FANTASTICA: PSEUDOLOGIA FANTASTICA This is a variation of Munchausen’s syndrome in which a person feels convinced that he is seriously ill and keeps on visiting many doctors in vain. 5/22/2013 107 A SUZY PRESENTATION PowerPoint Presentation: PSEUDOLOGIA FANTASTICA 5/22/2013 108 A SUZY PRESENTATION MEDICO-LEGAL IMPORTANCE: MEDICO-LEGAL IMPORTANCE The doctrine of diminished responsibility is applicable to an insane person who does an unlawful act due to delusion, which reduces his power of reasoning and understanding capacity, e.g. If he commits some act which is not directly related with the effect of delusion, but has indirect bearing, such a person cannot be regarded as fully responsible for his illegal acts. ( Section 84 IPC) 5/22/2013 109 A SUZY PRESENTATION HALLUCINATION: HALLUCINATION It is a false sensory perception which manifests without any external object or stimulus. They may occur in :- Schizophrenia Affective disorders Organic mental disorders They are also seen in insanity and conditions, like High fever Drug intoxication Withdrawal from drug addiction 5/22/2013 110 A SUZY PRESENTATION PowerPoint Presentation: HALLUCINATION 5/22/2013 111 A SUZY PRESENTATION TYPES OF HALLUCINATION: TYPES OF HALLUCINATION VISUAL AUDITARY OLFACTORY GUSTATORY TACTILE PSYCHOMOTOR LILLIPUTIAN SYNESTHESIA 5/22/2013 112 A SUZY PRESENTATION VISUAL HALLUCINATION: VISUAL HALLUCINATION The person may see lights or images or scenes. The patient experiences non –existent sights. He observes something without any being present. A person sees a plane in the sky when there is none. Such hallucinations are quite common in schizophrenia, epilepsy and drug withdrawal syndromes. Visual hallucination may be of following types:- Elementary type:-person sees only flashes of light. Partly organised:- person sees as patterns or unformed images. Completely organised:- person sees as images, figures or image of people, animal or object. 5/22/2013 113 A SUZY PRESENTATION PowerPoint Presentation: VISUAL HALLUCINATION 5/22/2013 114 A SUZY PRESENTATION AUDITORY HALLUCINATIONS: AUDITORY HALLUCINATIONS False perception of sound, usually noises, but also music. Here, the person hears voices of known or unknown persons without any source. They are quite common in schizophrenia. In some cases a person hears a command from God or Satan to do certain acts which may land up the person in conflict with law. They are also referred as COMMAND HALLUCINATIONS. Elementary type:-person hears only noises. Partly organised:- person hears only music. Completely organised:- person hears hallucinatory voices. 5/22/2013 115 A SUZY PRESENTATION PowerPoint Presentation: AUDITORY HALLUCINATIONS 5/22/2013 116 A SUZY PRESENTATION OLFACTORY HALLUCINATIONS: OLFACTORY HALLUCINATIONS Hallucination primarily involving smell or odors. There is false sense of smelling (pleasant/ unpleasant/sweet/sour/bitter) without any source. They are felt in schizophrenia and temporal lobe epilepsy. 5/22/2013 117 A SUZY PRESENTATION PowerPoint Presentation: OLFACTORY HALLUCINATIONS 5/22/2013 118 A SUZY PRESENTATION GUSTATORY HALLUCINATIONS: GUSTATORY HALLUCINATIONS Hallucinations involving taste. Without any food or drink, the patient experiences different taste. 5/22/2013 119 A SUZY PRESENTATION PowerPoint Presentation: GUSTATORY HALLUCINATIONS 5/22/2013 120 A SUZY PRESENTATION TACTILE/HAPTIC HALLUCINATIONS: TACTILE/HAPTIC HALLUCINATIONS They are hallucinations of abnormal touch. They are commonly seen in cocaine addiction where bugs or rats seems to be creeping in layers of skin.(Formication) Some patients experiences feeling of cold winds blowing on them or sensation of heat present over skin; actually things are not present. 5/22/2013 121 A SUZY PRESENTATION PowerPoint Presentation: TACTILE/HAPTIC HALLUCINATIONS 5/22/2013 122 A SUZY PRESENTATION LILLIPUTIAN (MICROPSIA) HALLUCINATIONS: LILLIPUTIAN (MICROPSIA) HALLUCINATIONS In this a person perceives objects to be of a much smaller size than they actually are. 5/22/2013 123 A SUZY PRESENTATION PowerPoint Presentation: LILLIPUTIAN (MICROPSIA) HALLUCINATIONS 5/22/2013 124 A SUZY PRESENTATION PSYCHOMOTOR/KINESTHETIC HALLUCINATION: PSYCHOMOTOR/KINESTHETIC HALLUCINATION There is feeling of movement of a part of the body, say a limb, though in reality, there is no such movement. 5/22/2013 125 A SUZY PRESENTATION PowerPoint Presentation: PSYCHOMOTOR HALLUCINATION 5/22/2013 126 A SUZY PRESENTATION SYNESTHESIA HALLUCINATION : SYNESTHESIA HALLUCINATION A stimulus perceived by a sensory organ other than the one that should actually perceive it. e.g. visualising music, hearing different colours, etc. 5/22/2013 127 A SUZY PRESENTATION PowerPoint Presentation: SYNESTHESIA HALLUCINATION 5/22/2013 128 A SUZY PRESENTATION SOME COMMON FACTS ABOUT HALLUCINATIONS : SOME COMMON FACTS ABOUT HALLUCINATIONS Visual hallucinations are the commonest in organic mental disorders (delirium tremens) Auditory hallucinations in functional (non-organic) disorders (schizophrenia) Gustatory hallucinations in temporal lobe epilepsy Olfactory hallucinations in medical disorders (especially in the temporal lobe) Tactile hallucinations in cocainism Auditory hallucinations are the commonest followed by visual Hallucinations are not under voluntary control and a person suffering from unpleasant hallucinations may be incited to commit suicide or homicide 5/22/2013 129 A SUZY PRESENTATION ILLUSION: ILLUSION It is false interpretation by the senses of an external object or stimulus which has real existence. Optical illusions are quite common in deserts where water may be seen at places. A rope may be seen as a snake at night. 5/22/2013 130 A SUZY PRESENTATION PowerPoint Presentation: ILLUSION 5/22/2013 131 A SUZY PRESENTATION TYPES OF ILLUSIONS: TYPES OF ILLUSIONS (a) Completion illusion: Where an unfinished pattern is completed by illusion. (b) Affect illusion: In this, mood of the person affects the nature of illusion. (c) Parabolic illusion: When human faces or images are seen in illusion. In illusion, the person may be corrected when confronted with facts. He realizes that it was a misinterpretation of stimulus. 5/22/2013 132 A SUZY PRESENTATION PowerPoint Presentation: Completion illusion 5/22/2013 133 A SUZY PRESENTATION PowerPoint Presentation: Affect illusion 5/22/2013 134 A SUZY PRESENTATION PowerPoint Presentation: Parabolic illusion 5/22/2013 135 A SUZY PRESENTATION IMPULSE: IMPULSE This is defined as a sudden and irresistible force which compels a person to do some action without motive or forethought , a normal person always tries to analyse his actions whether they are consistent with law or not. Once he realises that his action may be contrary to law he stops it. But in impulse, a person is not able to control himself. 5/22/2013 136 A SUZY PRESENTATION SOME COMMON TYPES OF IMPULSES: SOME COMMON TYPES OF IMPULSES (a) Kleptomania: An irresistible desire to steal things usually of low value. (b) Pyromania: An irresistible desire to set things on fire. (c) Mutilomania: An irresistible impulse to maim animals. (d) Dipsomania: An irresistible impulse to drink at periodic intervals. (e) Sexual impulses: All sexual perversions. (f) Homicidal impulses: To kill some persons. (g) Suicidal impulses: To commit suicide. Impulses are quite commonly seen in various mental disorders like depression, schizophrenia, mania, etc. (h) Trichotillomania: It is an irresistible desire to pull out one’s own hair (i) Oniomania: compulsive desire to shop (shopping addiction) 5/22/2013 137 A SUZY PRESENTATION PowerPoint Presentation: KLEPTOMANIA 5/22/2013 138 A SUZY PRESENTATION PowerPoint Presentation: PYROMANIA 5/22/2013 139 A SUZY PRESENTATION PowerPoint Presentation: MUTILOMANIA 5/22/2013 140 A SUZY PRESENTATION PowerPoint Presentation: DIPSOMANIA 5/22/2013 141 A SUZY PRESENTATION PowerPoint Presentation: SEXUAL IMPULSES/SEXUAL PERVERSIONS 5/22/2013 142 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 143 A SUZY PRESENTATION PowerPoint Presentation: SUICIDAL IMPULSES 5/22/2013 144 A SUZY PRESENTATION PowerPoint Presentation: TRICHOTILLOMANIA 5/22/2013 145 A SUZY PRESENTATION PowerPoint Presentation: ONIOMANIA 5/22/2013 146 A SUZY PRESENTATION OBSESSION: OBSESSION An obsession is defined as a persistent and irresistible thought, image, affect or impulse that cannot be removed by the sufferer although he knows that this is foolish. He continues to suffer. When this converts into action, it is called ‘compulsions’. The person keeps on repeating foolish behaviour though realising that it is untrue. Normal persons also sometimes have obsessions but they overcome them over a period of time. But once it becomes pathological, it may turn into obsessive compulsive neurosis 5/22/2013 147 A SUZY PRESENTATION COMMON EXAMPLES OF OBSESSION: COMMON EXAMPLES OF OBSESSION The person may keep on checking the locks even though he knows that he has bolted them well. The person may keep on washing hands for hours. 5/22/2013 148 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 149 A SUZY PRESENTATION SCHIZOPHRENIA: SCHIZOPHRENIA Eugen Bleuler introduced this term. Literally it means disintegration of mind. Commonly also called ‘split personality’. There is a complete loss of reality. The exact reason of schizophrenia is not known but it runs in families. Schizophrenia is a major illness. It is quite common in the lower strata of society. 5/22/2013 150 A SUZY PRESENTATION PowerPoint Presentation: SCHIZOPHRENIA 5/22/2013 151 A SUZY PRESENTATION SYMPTOMS: SYMPTOMS Diagnostic symptoms as proposed by Bleuler are summorised as :- (They are also called as 4 ‘A’ of Bleuler Ambivalence -inability to decide for or against Autism -withdrawal into self Affect disturbances -disturbance of feeling Association disturbance- loosening of association, thought disorder 5/22/2013 152 A SUZY PRESENTATION PowerPoint Presentation: AMBIVALENCE 5/22/2013 153 A SUZY PRESENTATION PowerPoint Presentation: AUTISM 5/22/2013 154 A SUZY PRESENTATION PowerPoint Presentation: AFFECT DISTURBANCES 5/22/2013 155 A SUZY PRESENTATION PowerPoint Presentation: ASSOCIATION DISTURBANCE 5/22/2013 156 A SUZY PRESENTATION TYPES OF SCHIZOPRENIA: TYPES OF SCHIZOPRENIA Simple schizophrenia: It is the commonest type. It mainly affects the mood of the person. He remains depressed, talks very little and is withdrawn. The motor activities are quite less. 5/22/2013 157 A SUZY PRESENTATION PowerPoint Presentation: SIMPLE 5/22/2013 158 A SUZY PRESENTATION TYPES OF SCHIZOPRENIA: TYPES OF SCHIZOPRENIA Hebephrenia: In this type, the thought process is primarily deranged. Incoherence of thoughts, delusions and hallucinations are reported. The motor activities are also quite less. 5/22/2013 159 A SUZY PRESENTATION PowerPoint Presentation: HEBEPHRENIA SCHIZOPRENIA 5/22/2013 160 A SUZY PRESENTATION TYPES OF SCHIZOPRENIA: TYPES OF SCHIZOPRENIA Catatonic: In this type, the behaviour of the person is primarily abnormal. There is a wild excitement and violent and abusive behaviour. Homicidal and suicidal tendencies are very high. The person may assault someone on minor provocations. Sometimes, the person may be so violent that he needs to be restrained by force. 5/22/2013 161 A SUZY PRESENTATION PowerPoint Presentation: CATATONIC SCHIZOPRENIA 5/22/2013 162 A SUZY PRESENTATION TYPES OF SCHIZOPRENIA: TYPES OF SCHIZOPRENIA Paranoid schizophrenia: Suspicion is the primary thought process in this type. The person may be thinking that some persons are behind him and can kill him. He may have suspicion about his wife, parents, kids, friends and colleagues. It occurs more in males than in females. Delusions are very common. Usually, personality is well preserved and these people are detected as suffering from mental illness after a long time. Auditory hallucinations are quite common. He may commit crime as he thinks people are after him. 5/22/2013 163 A SUZY PRESENTATION PowerPoint Presentation: PARANOID SCHIZOPHRENIA 5/22/2013 164 A SUZY PRESENTATION INSANITY: INSANITY The word “insane” has no technical meaning and is commonly used to refer to individuals who cannot take care of themselves or adhere to the social fabric, due to some mental disorder. It refers to individuals who by virtue of being mentally ill, are not competent to discharge their legal duties and are not aware of the legal implications of their behaviour. In the Indian Penal Code, the phrase ‘unsoundness of mind’ is used as synonymous to terms such as insanity, lunacy, madness or any mental disorder where a person is not capable of regulating his behaviour according to the socio-legal system. A medical officer is often called upon to opine whether a person is insane or not. He should not opine in a hurried manner, instead he should examine the person in detail and then express his opinion. 5/22/2013 165 A SUZY PRESENTATION CAUSES OF INSANITY: CAUSES OF INSANITY Heredity: Insanity often runs in families. The exact reason is not known. Usually, most of the mental diseases are not transmitted genetically but it has been observed that mental illness runs in families. 5/22/2013 166 A SUZY PRESENTATION CAUSES OF INSANITY: CAUSES OF INSANITY Environmental Factors: If during the early years of childhood, the upbringing of a child is not taken well care of, there are chances of developing mental illness. Attitude of both parents is very important in shaping good personality. Over protection, rejection, unnecessary peer comparison, or sibling rivalry can cause maladjustment in a child. Emotional maladjustment is quite common in adolescent period. A good sex education is very essential for adolescents to fashion their personality according to the social fabric. In adults, domestic quarrels, financial and business losses, failure in love, death of near ones, unemployment and job pressures can precipitate mental illness. 5/22/2013 167 A SUZY PRESENTATION CAUSES OF INSANITY: CAUSES OF INSANITY Organic Causes: Head injuries like cerebral haemorrhages, high fever and epilepsy may induce mental disorder. Addiction to alcohol, opium and dhatura may induce violent behaviour. Addiction to severe narcotics like heroin, cocaine and LSD may cause anti-social behaviour, and the person may commit crime. In severe, systemic diseases like uncontrolled hypertension, diabetes or other debilitating diseases, the person may land up in depression. 5/22/2013 168 A SUZY PRESENTATION ONSET OF INSANITY : ONSET OF INSANITY The onset of insanity is gradual. The person may be brought to the medical officer for treatment. In some cases the person may malinger to avoid punishment. So, the medical officer has to decide whether insanity is true or false 5/22/2013 169 A SUZY PRESENTATION Differentiate between and a true insane person and a person who is pretending to be an insane : Differentiate between and a true insane person and a person who is pretending to be an insane S.NO. FEATURES TRUE INSANE FEIGNED INSANE 1. Onset & Motive Usually gradual or rarely sudden but almost always without any motive. Always sudden and there is some motive. 2. Predisposing/exciting cause May be present, like h/o insanity in parents Not present. 3. Facial expression There are usually a peculiar characteristic facial expressions like worried look, agitated Normal or easily distinguishable. 4. Signs & Symptoms The true insane individual shows signs and symptoms of insanity irrespective of his conduct being observed or not. A false insane will show signs of insanity only when he is observed and there is total absence of symptoms when he thinks that he is alone or not being watched. 5. Characteristic feature Sign and symptoms usually point to a particular type of insanity. ( e.g. schizophrenia, mania, Bipolar disorder etc) A non insane person will do whatever comes in to his mind and his signs and symptoms don't indicate a particular type of insanity. 6. Effect of violent exertion Can stand violent exertion for several hours or days without exhaustion, perspiration or sleep. Violent exertion leads him to relaxation, exhaustion and sleep. 5/22/2013 170 A SUZY PRESENTATION Differentiate between and a true insane person and a person who is pretending to be an insane : Differentiate between and a true insane person and a person who is pretending to be an insane S.NO. FEATURES TRUE INSANE FEIGNED INSANE 7. Mood Excited, depressed or fluctuating May over react to show abnormality in mood 8. Habits Habits are invariably dirty or filthy. He may smear his body with stool or urine. Habits are not usually dirty or filthy. 9. Physical manifestation Dry harsh skin, furred tongue, constipation, anorexia (loss of appetite) Not present 10. Repeated examination Not worried about being repeatedly examined Shows dislike for repeated examinations. 11. Insomnia Present Cannot persist, patient usually sleeps after a day or two 12. Dressing up Carelessly dressed Dressed reasonably properly 5/22/2013 171 A SUZY PRESENTATION CLASSIFICATION OF MENTAL DISEASES: CLASSIFICATION OF MENTAL DISEASES The classification of mental diseases is done according to two well-accepted methods which are as follows: 1. DSM IV: This is an American system. It stands for Diagnostic and Statistical Manual of Mental Disorders, IVth edition 1994. 2. ICD-10: It means international classification of diseases, injuries and cause of death, 10 th edition, 1992. ICD-10 classification is more popular and is followed worldwide. The following is the classification of mental diseases according to the World Health Organisation: 5/22/2013 172 A SUZY PRESENTATION CLASSIFICATION OF MENTAL DISEASES: CLASSIFICATION OF MENTAL DISEASES 1.Psychosis (Major Illness): It may be of following types: (a) Organic psychosis: When there is an organic cause associated with psychosis, it is called ‘organic psychosis’. Common examples are alcoholic psychosis, psychosis following head injury, endocrine disturbances, old age, epilepsy, drug dependence, etc. (b) Functional psychosis: In this, there is no apparent cause of psychosis. It is of following types: (i) Schizophrenia. (ii) Manic-depressive illness. (iii) Paranoid state. 5/22/2013 173 A SUZY PRESENTATION CLASSIFICATION OF MENTAL DISEASES: CLASSIFICATION OF MENTAL DISEASES 2. Neurosis (Minor Illness): The following are the common types of neurosis: (i) Anxiety neurosis. (ii) Depression. (iii) Hypochondriacal. ( iv) Obsessive compulsive neurosis. (v) Hysterical neurosis. 3. Personality Disorders as in Psychopaths. 4. Sexual Perversions. 5. Drug Dependence. 5/22/2013 174 A SUZY PRESENTATION MENTAL RETARDATION : MENTAL RETARDATION "Mental retardation refers to significantly sub average general intellectual functioning existing concurrently with deficits in adaptive behavior, and manifested during the developmental period". 5/22/2013 175 A SUZY PRESENTATION MENTAL HANDICAP : MENTAL HANDICAP It refers to mental sub normality in an individual, acquired at the time of birth or early childhood. Intelligent quotient is low. It is usually of the following types: 5/22/2013 176 A SUZY PRESENTATION IDIOCY: IDIOCY Here, I.Q. level is around 20. The person is mentally retarded severely. He may be associated with some other genetic problems too. He may need physical and mental rehabilitation to lead a normal life. Usually, idiots remain cheerful as their achievement goals are almost absent and they can lead their life easily on a survival basis. 5/22/2013 177 A SUZY PRESENTATION IMBECILE: IMBECILE Their I.Q. level is between 20 and 50. They are incapable of managing their affairs themselves. They also require physical and mental rehabilitation by a therapist to lead a normal life. 5/22/2013 178 A SUZY PRESENTATION FEEBLE MINDEDNESS: FEEBLE MINDEDNESS Their I.Q. level is between 50 and 75. They appear normal but their mental faculties, especially intelligence, is less as compared to a normal person. They are usually school dropouts. They do not fare well in academic and financial career. They may get easily involved in criminal activities 5/22/2013 179 A SUZY PRESENTATION CLASSIFICATION OF MR : CLASSIFICATION OF MR Level of Retardation IQ Mild retardation 50-69 Moderate retardation 35-59 Severe retardation 20-34 Profound retardation < 20 5/22/2013 180 A SUZY PRESENTATION PSYCHOSIS: PSYCHOSIS 5/22/2013 181 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 A SUZY PRESENTATION 182 MENTAL HEALTH ACT 1987 THE MENTAL HEALTH ACT, 1987 : THE MENTAL HEALTH ACT, 1987 An Act to consolidate and amend the law relating to the treatment and care of mentally ill persons, to make better provision with respect to their property and affairs and for matters connected therewith or incidental thereto. 5/22/2013 183 A SUZY PRESENTATION THE MENTAL HEALTH ACT, 1987 : THE MENTAL HEALTH ACT, 1987 It replaces the Indian Lunacy Act of 1912 resulting in change of certain terminologies as shown below Asylum to psychiatric hospital Lunatic to mentally ill person Criminal lunatuc to mentally ill prisoner The mental health act came into affect only in April 1993 in all the states and union territories of India. 5/22/2013 184 A SUZY PRESENTATION OBJECTIVES OF THE ACT : OBJECTIVES OF THE ACT Regulate admission of the mentally ill patient to a psychiatric hospital or psychiatric nursing home and to protect his rights while under detection Prevent harm to himself and the society by the mentally ill person Protect citizens being detained in psychiatric hospitals without sufficient cause. …………….cont………….. 5/22/2013 185 A SUZY PRESENTATION OBJECTIVES OF THE ACT : OBJECTIVES OF THE ACT Fix liability for maintenance charges of mentally ill patient admitted to the hospital or nursing home. P rovide facilities to establish guardianship or custody of the mentally ill patient and management of his property. Establish central and state authority for mental health services Provide licensing and control of psychiatric hospitals by the state government Ensure legal aid to the mentally ill person at state expense in certain cases 5/22/2013 186 A SUZY PRESENTATION MENTAL DISORDER AND RESPONSIBILITY: MENTAL DISORDER AND RESPONSIBILITY Responsibility, in the legal sense, means the liability of a person for his acts or omissions, and if these are against the law, the liability to be punished for them. The law presumes that every person is mentally sound, until the opposite is proved. 5/22/2013 187 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 A SUZY PRESENTATION 188 CIVIL RESPONSIBILITY: CIVIL RESPONSIBILITY The question of civil responsibility arises in following conditions:- Management of property and affairs Insanity and contracts Insanity and marriage contract Competence of insane to be a witness Consent and insanity Insanity and testamentary capacity 5/22/2013 189 A SUZY PRESENTATION MANAGEMENT OF PROPERTY AND AFFAIRS: MANAGEMENT OF PROPERTY AND AFFAIRS If a person who owns property becomes insane and is incapable of managing his affairs with sound judgment, a relative or friend can approach the court for judicial inquisition. The medical evidence is given in the form of a certificate which should state “that insanity is of such a degree as to make him incapable of managing his property.” On enquire if it’s found that the person is incapable of managing his property the court can appoint a guardian or manager depending on the circumstances. The court may order the sale or disposal of the person’s property, for the payment of his debts and expenses. The court may order a second inquisition, if it’s reported that unsoundness of mind had ceased. 5/22/2013 190 A SUZY PRESENTATION BUSINESS CONTRACT : BUSINESS CONTRACT If it is proved that at the time of signing a contract one of the two parties was insane, then the contract becomes legally invalid. Insanity developing subsequently to a legal agreement will not necessarily invalidate the contract. If at the time of signing, the fact that one of the signatories to the contract was insane was not known to the other party, the contract may not be declared invalid. For the purpose of a contract, a person is said to be of sound mind if at the time of making the contract, he is capable of understanding it and forming a rational judgment. 5/22/2013 191 A SUZY PRESENTATION MARRIAGE : MARRIAGE A marriage is considered invalid if at the time of marriage, either party is 1) Incapable of giving valid consent due to insanity. 2) Though capable of giving valid consent, has been suffering from such kind or degree of mental disorder as to be unfit for marriage or procreation. 3) Has been suffering from recurrent attacks of insanity. 5/22/2013 192 A SUZY PRESENTATION THE COMPETENCE OF INSANE TO BE A WITNESS : THE COMPETENCE OF INSANE TO BE A WITNESS An insane person is not competent to give evidence, if he cannot understand the necessity of telling the truth due to insanity. A person of unsound mind who suffers from delusions, but is capable of telling what he has seen and who understands the importance of an oath, is competent to give evidence An insane person is competent to give evidence during the lucid interval. 5/22/2013 193 A SUZY PRESENTATION CONSENT AND INSANITY : CONSENT AND INSANITY Consent to certain acts like, sexual intercourse or hurt is not valid, if such consent is given by a person who due to unsoundness of mind is unable to understand the nature and consequences of the act. 5/22/2013 194 A SUZY PRESENTATION TESTAMENTARY CAPACITY: TESTAMENTARY CAPACITY Testamentary capacity refers to the capacity of a person to make a valid will. The law defines it as possession of a sound disposing mind (corpus mentis) which must be certified by a doctor. A will is a document detailing the disposition of property owned by a person, which is prepared by him during his lifetime but takes effect only after his demise. The person who makes the will is referred to as the testator. Will written by the testator in his own handwriting is called “Holograph will”. It can be revoked or changed any number of times 5/22/2013 195 A SUZY PRESENTATION ELIGIBILITY FOR MAKING A WILL : ELIGIBILITY FOR MAKING A WILL As per Indian succession act 59, the following persons are eligible to make a valid will Every person of sound mind who is over age of 18 years An insane person cannot write a valid will unless he is in a lucid interval. An intoxicated person cannot make a will, unless it is certified by a doctor that he was under his senses A deaf dumb or blind person can make a will if he can communicate effectively Convicts are not debarred from making a will. 5/22/2013 196 A SUZY PRESENTATION PROCEDURE : PROCEDURE The will must always be in writing, the only exception provided under law is for members of the armed forces who are out on expedition or engaged in warfare. They can make an oral will (privileged will). Muslims are permitted to make an oral will by their personal law. There is no particular format for a will. It need not be even on a stamp paper. The testator can write a will himself using a fountain or ball pen (holographic will). The will must be attested by at least 2 witnesses, neither of them can be beneficiaries. It is preferable that one of them should be a doctor. The signature or thumb impression of the testator is mandatory The will comes into effect only on the death of the testator. 5/22/2013 197 A SUZY PRESENTATION CONDITIONS : CONDITIONS The person making a will should Have a sound disposing mind Have thorough knowledge about his wealth and property Be free from undue influence, or fraud Do it voluntarily 5/22/2013 198 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 A SUZY PRESENTATION 199 CRIMINAL RESPONSIBILITY CRIMINAL RESPONSIBILITY OF THE INSANE: CRIMINAL RESPONSIBILITY OF THE INSANE MCNAUGHTON'S RULE In 1843, one person named McNaughton, under delusion of persecution shot dead Mr. Drummond, the private secretary of Sir Robert Peel, Prime Minister of England. In fact, he wanted to kill Sir Robert Peel but since he could not identify him properly, he shot dead Mr. Drummond by mistake. He was later arrested and sent to prison. Since he was insane and there was no English law at that time to fix criminal responsibility of an insane, a committee of 14 judges were constituted to frame law which resulted in “McNaughton's Rule” or “Legal Test” according to English law which states as follows: ……cont… 5/22/2013 200 A SUZY PRESENTATION CRIMINAL RESPONSIBILITY OF THE INSANE: CRIMINAL RESPONSIBILITY OF THE INSANE That to establish a defense on the ground of insanity, it must be clearly proved that “at the time of committing the act, the accused was laboring under such a defect of reason, from disease of the mind, as not to know the nature and quality of the act he was doing, or, if he did know it, that he did not know he was doing what was wrong.” …..cont………….. 5/22/2013 201 A SUZY PRESENTATION CRIMINAL RESPONSIBILITY OF THE INSANE: CRIMINAL RESPONSIBILITY OF THE INSANE In India, Section 84 of the I.P.C . defines the legal test or criminal responsibility of the insane, as: “Nothing is an offence which is done by a person who, at the time of doing it, by reason of unsoundness of mind, is incapable of knowing the nature of the act, or that he is doing what is either wrong or contrary to law.” Section 85 of the I.P.C. defines legal responsibility of a person under intoxication. If it is proved that a person was given intoxication without his knowledge or against his will, and due to intoxication he lost mental reasoning and then committed the crime, he will not be held responsible for it. Drunkenness caused by voluntary use of alcohol or drugs offers no excuse for committing the crime. 5/22/2013 202 A SUZY PRESENTATION Loss of Self-control or Sudden and Grave Provocation: Loss of Self-control or Sudden and Grave Provocation Sometimes, a person may lose self-control, or there is sudden and grave provocation, and as a result, he may commit crime. Common situation is that, if a person sees his wife teased by goons, he may lose self-control and may kill any goon. In such cases doctrine of partial responsibility is used and the murder may be charged the under Section 304 of the I.P.C. rather than Section 302 of the I.P.C. Section 304 the of I.P.C. prescribes less sentence as compared to Section 302 of the I.P.C. 5/22/2013 203 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 A SUZY PRESENTATION 204 LOSS OF SELF-CONTROL OR SUDDEN AND GRAVE PROVOCATION HYPNOSIS: HYPNOSIS It is also a sleep-like stage, indeed by suggestion. But it is very difficult to convince a person in hypnosis to commit some act which he would not do in normal circumstances. It is a wrong impression that a person may commit murder under hypnosis. 5/22/2013 205 A SUZY PRESENTATION PowerPoint Presentation: 5/22/2013 A SUZY PRESENTATION 206 SOME RECENT GUIDELINES: SOME RECENT GUIDELINES One of the major defects in the McNaughton's Rule, is that, from deciding that a person is insane, only cognitive (intellectual) faculties are taken into consideration, where as emotional factors, hallucination and the ability of the individual to control the impulse (resistible impulse) are not considered. So, these neurotic disorders are not given any importance. Some western countries have taken this into consideration and have formulated some guidelines. Some of them are known as: Durham Rule (1954) Curren’s Rule (1961) American Law Institute Test. (1970) The Brawner rule (1972) The Irresistible impulse 5/22/2013 207 A SUZY PRESENTATION DURHAM RULE (1954) : DURHAM RULE (1954) The Durham rule states that an accused is not criminally responsible if his unlawful act was the product of mental disease or mental defect. The Durham rule was eventually rejected by the federal courts, because it cast too broad a net. Alcoholics, compulsive gamblers, and drug addicts had successfully used the defense to defeat a wide variety of crimes. The federal insanity defense, established by the Comprehensive Crime Control Act, now requires the defendant to prove, by "clear and convincing evidence," that "at the time of the commission of the acts constituting the offense, the defendant, as a result of a severe mental disease or defect, was unable to appreciate the nature and quality or the wrongfulness of his acts". 5/22/2013 208 A SUZY PRESENTATION CURREN’S RULE (1961): CURREN’S RULE (1961) An accused person will not be held criminally responsible, if at the time of committing act, he did not have the capacity to regulate his conduct to the requirement of law, as a result of mental disease or defect. As per Curren’s rule, it was contested that, at the time of committing the criminal act, a person may have the knowledge that what he was doing was wrong but he neither had the capacity nor the will to control (adjust) his act. Therefore such person should not be held responsible. 5/22/2013 209 A SUZY PRESENTATION AMERICAN LAW INSTITUTE TEST. (1970): AMERICAN LAW INSTITUTE TEST. (1970) A person is not responsible for his criminal conduct if at the time of such conduct as a result of mental disease or defect, he lacks substantial capacity either to appreciate the wrongfulness of his conduct or to adjust his conduct to the requirement of law. 5/22/2013 210 A SUZY PRESENTATION THE BRAWNER RULE (1972): THE BRAWNER RULE (1972) According to this rule, insanity should be decided by a jury. Under this proposal, juries are allowed to decide the “ insanity question” as they see fit. 5/22/2013 211 A SUZY PRESENTATION IRRESSISTABLE IMPULSE : IRRESSISTABLE IMPULSE An accused person is not criminally responsible, if he knows the nature and quality of his act and knows that it is wrong, if he is incapable of restraining/control himself from committing the act because the free agency of his will has been destroyed by mental disease. In 1994. Lorena Bobbitt was found not guilty of a crime, when her defense argued that an irresistible impulse led her to cut off her husband’s penis. 5/22/2013 212 A SUZY PRESENTATION PowerPoint Presentation: 213 THANK YOU … WE NEED LOT OF SUGGESTIONS PLEASE…..